Beetroot Powder and Altitude Training: Why Elite Teams Use Dietary Nitrate at Elevation

Elite cycling and running teams that conduct altitude training camps increasingly include dietary nitrate as a standard protocol component. The reason is straightforward: at elevation, where oxygen partial pressure is lower than at sea level, the mechanisms through which dietary nitrate improves performance are amplified.

This post explains why altitude makes dietary nitrate more effective, what the research shows, and how to implement a practical protocol for athletes training or competing above 1,500 meters.

Why Altitude Creates a Performance Problem

At sea level, inspired air contains approximately 21 percent oxygen at a partial pressure of about 159 mmHg. At 2,000 meters (6,560 feet), the oxygen partial pressure drops to roughly 133 mmHg. At 3,000 meters, it falls to around 110 mmHg.

The practical consequence for endurance athletes: the blood leaves the lungs less fully saturated with oxygen (SpO2 drops from ~98 percent at sea level toward 90 to 94 percent at moderate altitude), and the working muscles receive less oxygen per liter of blood delivered. Cardiac output increases to compensate, heart rate at a given power rises, and maximum sustainable effort decreases.

For a cyclist who can hold 350 watts for an hour at sea level, the same perceived effort at 2,500 meters might yield 310 to 320 watts. For a marathon runner, the 3:00 per kilometer pace that feels controlled at sea level requires noticeably more effort at altitude. This performance decrement is the fundamental problem that altitude acclimatization attempts to solve over 2 to 4 weeks.

How Dietary Nitrate Helps at Altitude

Nitric oxide (NO) is produced through two pathways in the body. The enzymatic pathway, involving nitric oxide synthase (eNOS), uses oxygen as a substrate. At altitude, reduced tissue oxygen availability impairs eNOS activity and reduces enzymatic NO production.

The second pathway, the nitrate-nitrite-nitric oxide pathway, is oxygen-independent. Dietary nitrate is reduced to nitrite by bacteria in the mouth, and nitrite is then converted to nitric oxide in the stomach and tissues through reactions that do not require oxygen. Under hypoxic (low-oxygen) conditions, this pathway becomes more active, not less.

The practical implication: when altitude suppresses the oxygen-dependent NO production pathway, dietary nitrate supplementation maintains nitric oxide availability through the complementary oxygen-independent route. The nitric oxide that would normally be lost due to altitude-induced hypoxia is partially restored through dietary nitrate intake.

A 2015 study by Muggeridge et al. demonstrated this mechanism directly. Trained cyclists who consumed dietary nitrate before a time trial at simulated altitude (2,500 meters) showed improved performance compared to placebo, with a greater effect at altitude than at sea level. The researchers attributed the amplified effect to the upregulation of the nitrate-to-nitrite-to-NO pathway under hypoxic conditions.

The Altitude Training Camp Protocol

For athletes attending altitude training camps (typically 2,000 to 3,500 meters, lasting 2 to 4 weeks), dietary nitrate supplementation is most useful in two phases:

Arrival and early adaptation (days 1 to 7): This is the period of maximum performance decrement. SpO2 is at its lowest relative to the athlete's sea-level baseline. EPO production ramps up but red blood cell mass has not yet increased. Dietary nitrate can partially compensate for impaired NO production during this window. Recommended: 1 serving per day, 60 to 90 minutes before the key training session.

Taper and return to sea level: Athletes returning from altitude camps have elevated red blood cell mass but want to maintain the supplemental NO benefit during the initial 2 to 4 week window when the altitude adaptation is expressing at sea level. Continuing daily dietary nitrate use during this period stacks the hematological benefit from altitude with the hemodynamic benefit of dietary nitrate.

For racing at altitude (mountain gran fondos, road races held above 2,000 meters, trail running events), use the same protocol as sea-level competition: 3-day loading (one AM plus one PM serving) followed by one serving 60 to 90 minutes before the start.

See the complete loading protocol for all timing and dosing details.

What Elite Teams Actually Do

Multiple WorldTour cycling teams have published or disclosed their altitude camp supplementation protocols through athlete interviews and team nutritionist presentations at sports science conferences. The consistent pattern: dietary nitrate (typically as beet juice concentrate or a standardized extract) is used daily during altitude camps, specifically to maintain oxygen delivery during the low-acclimatization phase.

The Kenyan and Ethiopian running programs that have historically dominated altitude-adapted distance running are typically based in regions where the local diet is naturally high in dietary nitrate from leafy vegetables and root vegetables. Whether this dietary nitrate contributes to their altitude tolerance is an open question, but the coincidence has not escaped the attention of sports scientists.

Altitude-Specific Considerations

Mouthwash: The oral bacteria responsible for converting dietary nitrate to nitrite are suppressed by antibacterial mouthwash. At altitude, where the nitrate-to-NO pathway is especially important, using antibacterial mouthwash on training days would blunt the supplement's effectiveness more than at sea level. Avoid antibacterial mouthwash entirely during altitude blocks.

Hydration: Altitude increases respiratory water loss and often increases urine output. Dietary nitrate absorption is not affected by hypohydration at levels commonly seen in altitude athletes, but gastric emptying slows with dehydration, which can delay the onset of effect. Maintain normal hydration and take your serving with 300 to 500 mL of water.

Iron status: Iron deficiency impairs hemoglobin synthesis and limits the altitude adaptation response. Dietary nitrate does not substitute for adequate iron status. If you are altitude training for the hematological benefit, verify your ferritin levels are adequate (ideally above 30 mcg per liter) before the camp.

Complementary Supplements at Altitude

The IOC recognizes dietary nitrate as one of five evidence-based supplements for endurance athletes. At altitude, the other four remain relevant:

Caffeine retains its CNS performance effects at altitude and is not blunted by hypoxia. Creatine can support the high-intensity efforts in interval sessions at altitude, where phosphocreatine recycling is relevant. Beta-alanine (via Endurance360) loaded for 4 to 6 weeks before an altitude camp ensures maximal carnosine buffering capacity during the demanding early acclimatization sessions.

See the IOC supplement overview for the full picture.

How Beetroot Pro Delivers a Clinical Dose

The key variable in any altitude supplement protocol is dose certainty. A 2021 review published in PMC analyzed 28 commercial beet products and found nitrate content ranging from 4.3 mg to 495.7 mg per serving, with most products falling well below the clinical threshold of 300 mg.

At altitude, where every milligram of nitrate-derived NO matters, using a product that delivers an undisclosed or sub-clinical dose is the same as using no product at all. Beetroot Pro uses patented betaine nitrate to deliver a standardized dose confirmed by the published Supplement Facts label, putting it in the clinical range that altitude research requires.

Compare dose transparency across product formats at the supplement comparison page.

FDA Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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